Impact of calcification and intraluminal thrombus on the computed wall stresses of abdominal aortic aneurysm Zhi-Yong Li, PhD, Jean U-King-Im, MRCS,

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Impact of calcification and intraluminal thrombus on the computed wall stresses of abdominal aortic aneurysm Zhi-Yong Li, PhD, Jean U-King-Im, MRCS, FRCR, Tjun Y. Tang, MRCS, Edmund Soh, MRCP, FRCR, Teik Choon See, FRCR, Jonathan H. Gillard, MD, FRCR Journal of Vascular Surgery Volume 47, Issue 5, Pages 928-935 (May 2008) DOI: 10.1016/j.jvs.2008.01.006 Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 1 A, Cross-sectional computed tomography image shows an abdominal aortic aneurysm. B, Segmentation of calcification, intraluminal thrombosis, arterial wall, and lumen. Journal of Vascular Surgery 2008 47, 928-935DOI: (10.1016/j.jvs.2008.01.006) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 2 Three-dimensional model derived from the computed tomography reconstruction of the abdominal aortic aneurysm (AAA). A, Reconstruction of the AAA shows the AAA components (calcification, intraluminal thrombus, arterial wall, and lumen). B, Three-dimensional mesh of the AAA model. C, Longitudinal cross-section of the AAA model shows the detail meshes of the AAA components. Journal of Vascular Surgery 2008 47, 928-935DOI: (10.1016/j.jvs.2008.01.006) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 3 Three-dimensional wall stress distributions among the three abdominal aortic aneurysm models are compared: (A) unaltered model, (B) no-calcification model, (C) no-intraluminal thrombus (ILT) model. Journal of Vascular Surgery 2008 47, 928-935DOI: (10.1016/j.jvs.2008.01.006) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 4 Box and whisker plot of maximum von Mises stresses within the unaltered, no-calcification, and no-intraluminal thrombosis models of abdominal aortic aneurysms. The horizontal line in the middle of each box indicates the median; the top and bottom borders of the box mark the 75th and 25th percentiles, respectively. The whiskers mark the 90th and 10th percentiles. The circle represents an outlier. Journal of Vascular Surgery 2008 47, 928-935DOI: (10.1016/j.jvs.2008.01.006) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 5 Relationship of abdominal aortic aneurysm components to maximum von Mises stresses. A, Correlation of stress (in kPa) with percentage volume of calcification. The correlation between percentage volume of calcification and stress was not significant (P =.450). B, Correlation of stress with percentage volume of intraluminal thrombus (ILT). There was a significant moderate negative correlation between stress and percentage volume of ILT (r = −0.56; P =.011). Journal of Vascular Surgery 2008 47, 928-935DOI: (10.1016/j.jvs.2008.01.006) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions

Fig 6 Relationship of abdominal aortic aneurysm (AAA) components to maximum ad minimum stresses. A, Correlation between changes in stress when calcification was replaced within arterial wall and percentage volume of calcification in unaltered AAA. A significant correlation was found (r = 0.685; P = .001). B, Correlation between changes in stress with and without intraluminal thrombosis (ILT) and percentage volume of ILT in unaltered AAA. This correlation was also significant (r = 0.863; P < .001). Journal of Vascular Surgery 2008 47, 928-935DOI: (10.1016/j.jvs.2008.01.006) Copyright © 2008 The Society for Vascular Surgery Terms and Conditions